Abstract
Pakistans large and rapidly growing population challenges the country's ability to provide essential services, economic opportunities, and a good quality of life for its citizens. Furthermore, high total fertility rates put children and women at greater risk for higher mortality and poor overall health. Most non-first births in Pakistan fall into the high-risk category, and infant and maternal mortality rates remain high. Evidence shows that longer intervals between births can reduce the incidence of both neonatal and maternal mortality. Pakistan instituted a comprehensive and detailed family planning program in the mid-1960s to address the impact of poor birth spacing and high fertility and has continued to explore different approaches to expand family planning services, improve quality, and reach underserved areas. Family planning services were delivered primarily through the separate Population and Welfare Ministry and not connected to the Ministry of Health services.